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Anatomo physiological features of newborns 1 3 months. Features of the formation of the heart, vessels and the immune system. Liver physiology in newborns

Physiology of newborns includes many aspects - thermoregulation, water-salt exchange, physiology of cardiovascular, respiratory, immune systems, kidneys, liver, blood, and feeding.

Thermoregulation of newborns

Due to the characteristics of the physiology of newborns, they are included in the risk group of hypothermia due to the high ratio of body area to mass. The persistent hypothermia can lead to metabolic acidosis due to a combination of reduced blood circulation with metabolic needs. The vicious hypoxic circle may develop when the hypothermia causes a spasm of pulmonary arteries, which leads to an increase in blood shunting with the right to levo through arterial duct. This can enhance hypoxemia and acidosis. To prevent the heating loss of the newborn, swaded; The child with increased heat transfer is placed in a temperature controlled or under the source of thermal radiation. Newborns with a surgical disease have an additional risk of hypothermia during transportation, as well as in the operating room, in which it is necessary to increase the temperature and, if possible, put the child in warm diapers to maintain the body temperature at 37 degrees.

Physiology of the cardiovascular system in newborns

The fetal has three shunts, which are normal in the norm after birth. These shunts, along with a high ffeeding of fetal hemoglobin to oxygen, allow the fetus to overcome relative hypoxia in the uterus. Oxygenated blood from the placenta falls through the umbilical veins and largely goes around the liver through the venous duct - Ductus Venosus. Then the blood enters the NPV and the right ventricle. Two ventricle of the fetus work at the same time, supplying blood into systemic blood flow. A piece of oxygenated blood from the NPB through the shunt represented by the oval hole enters the left heads of the heart, from where it gets mainly in the coronary blood flow and the brain. The remaining part of the blood enters the right hearts of the heart, where it is mixed with poor blood blood from the EPV. A larger volume of this mixed blood comes out of the right ventricle and returns to the heart and pulmonary blood flow through the existing arterial duct, which connects the pulmonary artery and aorta. After leaving the arterial duct, blood is spread to the abdominal organs, lower limbs, placenta.

The transition from fetal blood circulation to the blood circulation inherent in the organism of an adult is carried out due to numerous changes in the physiology of the newborn after birth. After childbirth, low-member placental blood circulation disappears, which leads to an increase in the overall resistance of blood flow at the outlet of the left ventricle and the systemic blood flow. Refractions of the lungs during the first inhalation of the newborn leads to a decrease in resistance in pulmonary vessels. The resistance change in ventricular paths leads to the functional closure of the oval hole. The level of pulmonary hypertension changes immediately after birth - the pressure in the pulmonary artery becomes less than in the aorta or systemic blood flow. Any residual (residual) shunting is now carried out through arterial duct left to right from the aorta to pulmonary blood flow. Normally, an increase in blood oxygen in oxygen at the moment of birth leads to the expansion of pulmonary vessels and the closure of arterial duct. In this process, prostaglandins are likely to take part. Sometimes, especially in premature babies, there is a violation of the closure of arterial duct. These children keep shutting from left to right through arterial duct; The presence of such a shunt is a risk risk of fluid delay and lungs. And, on the contrary, in newborns with the continuing pulmonary hypertension due to prematurity, hypoxia or congenital defects of heart development, it is possible to shunt the right to left and the discharge of blood oxygen into bulk of the lungs into systemic blood flow, which can increase hypoxia. In any embodiment, if there is an arterial duch, it requires its closure of pharmacological (using indomethacin) or surgically.

The small size of the ventricles of the heart in the physiology of newborns does not cope with the increase in the diastolic volume (preload) and, accordingly, the shock volume does not increase. The preferential mechanism for increasing heart emissions is to increase the heart rate than in increasing the shock volume. Newborn with congenital heart defects, for example, Tetraja Fallo and DMWP are particularly sensitive to physiological stress requiring mobilization of cardiac reserves. To exclude congenital heart defects, echo-kg perform.

Physiology of the respiratory system in newborns

The respiratory system is formed from the embryonic gastrointestinal tract for 3-4 weeks of embryonic development. Fuchery and bronchi are formed from the lengthening of the front of the esophagus. As a result of the interaction of respiratory endoderma and the surrounding mesoderm, branches of bronchi and terminal alveoli are formed. Structural and functional components of the lungs continue to grow and ripen during pregnancy and after birth. Easy fetus is not able to provide adequate gas exchange to 23-24 weeks of gestation; This period and determines the lower limit of the off-borne survival. This period also begins the synthesis of second-type surfactant alveolocytes. This glycoprotein rich in phospholipids prevents the alvetol falling due to the reduction of surface tension and contributes to gas exchange.

Physiology of kidney in newborns

All body fluid in newborns physiology is divided into intracellular and extracellular; By 32 weeks, water is about 80% of the mass of the fetus; By birth, its share decreases to 70%. During the 1st week of life, the newborn baby quickly loses from 5 to 10% of the total fluid volume. In premature babies, due to the greater total volume of fluid at birth, the symptoms of the overload with liquid during the 1st week of life due to the inadequate removal of its excess. The large volume of circulating fluid may increase the likelihood of functioning of arterial duct, lack of left ventricle, RDS, necrotizing colitis. By the end of the first year of life, the total volume of fluid reaches a level characteristic of an adult (about 60% of body weight).

The kidney function in the physiology of the newborn is significantly different from the adult kidney function. The speed of glomerular filtration (SCF) in the newborn is the fourth part of the adult SCF. Due to the fact that the kidney regulation of the level of potassium depends on the SCF, newborns, especially premature, are included in the risk of the development of hyperkalemia. The concentration ability of the newborn kidney is also lower due to low sensitivity to antidiuretic hormone.

The kidneys of dead newborns are able to concentrate urine to 600 mos / kg, and in adults concentration ability reaches 1200 mos / kg. The kidney of the newborn is capable of detaining sodium by excretion of diluted urine (below 30 MOS / kg against 100 mos / kg in adults). These two features explain the exposure of the physiology of the newborn to hypernatremia. Therefore, it is very important to the reasonable introduction of liquids and electrolytes to children who do not receive oral nutrition. In the first day, administration begins with a 5% solution of dextrose, and then 5% dextrose divorced by half a physiological solution is introduced. The newborn must allocate 1-2 ml / kg of urine per hour with osmolality approximately 250 mos / kg.

Liver physiology in newborns

Due to the immaturity of liver enzymes in the physiology of newborns, they are subject to cholestase and overdose of medicinal substances. For example, the immaturity and deficiency of the enzyme enzyme glucowerransferase responsible for the conjugation and the excretion of bilirubin can lead to a physiological jaundice at the 1st week of the child's life. With the rapid increase in the level of non-conjugated bilirubin, phototherapy is required or, rarely, blood transfusion. Exchange transfusion is carried out to prevent nuclear jaundice toxic for the central nervous system and due to the deposition of an unbound bilirubin in basal ganglia. Nuclear jaundice can manifest itself with convulsions, hearing loss, mental retardation and central paralysis.

Immunology newborns

Bacterial colonization begins during childbirth. By the third day of life, the skin and the upper heights of the respiratory system are settled by gram-positive microorganisms. At the age of 1 week, gram-negative, aerobic and anaerobic bacteria populate the gastrointestinal tract. Hospitalized children are settled with more virulent strains of microorganisms, which are present in the children's office and on medical instruments, so such children have a high risk of systemic infection. The mucous-skin barrier in the physiology of newborns consisting of a holistic mucous membrane, produced mucus, immunoglobulins, local flora, coordinated peristaltic, acidic content of the stomach, various enzymes, can be weakened in newborns, especially in premature, and is not able to prevent opportunistic infection due to bacterial Colonization. The main disease and medical manipulation, for example, intubation or catheterization, increase the risk of infectious complications.

For the physiology of newborns, cellular and humoral immunodeficiency is characteristic. Neutrophils and macrophages reduced chemotactic and adhesive ability; The complement system operates by 50% of the adult activity; Reduced T cell activity. Most newborn also has a relative immunodeficiency at birth, which causes an increase in the risk of infection with encapsulated microorganisms and viruses. In the first months of life, breast milk can compensate for most of the immune failure. Breast milk is important for the physiology of newborns, and contains segmented leukocytes, macrophages, lymphocytes, complement, enzymes, lactoferrin, lysozyme, interferon and various growth factors. The above provides passive protection of a newborn until the maturation of its own immune system.

Hematology

The blood volume of the premature newborn is about 100 ml / kg, and in the docking - 80-85 ml / kg. If more than 10% of the total blood volume, replacement therapy is recommended; The volume of transfusion depends on the initial concentration of hemoglobin. For example, a newborn weighing 3.2 kg and blood volume of 250 ml, which lost 25 ml during surgery, was shown substituable blood transfusion. The blood loss is reimbursed by the erythrocyte mass at the rate of 10 ml / kg, every 10 ml of the erythrocyte mass increase hematocrit 3%.

In normal physiology, the newborn is observed by polycythemia, the level of hemoglobin is 15-20 g / l. Subsequently on the 3-5th month of life, when moving fetal hemoglobin to adult type, the child develops physiological. Platelet level in a newborn such as an adult; When developing thrombocytopenia, it is necessary to exclude systemic infection. The newborn may also have a deficit of blood coagulation factors V, XIII, vitamin K-dependent factors (II, VII, IX, X). Vitamin K is prescribed by all newborns to prevent hemorrhagic diseases of newborns. Newborn with continuing bleeding should be examined on hereditary collapses, vitamin K deficiency, platelet disorders, DVS syndrome. The cause of bleeding is detected when collecting anamnesis, conducting an objective examination, laboratory tests, including the protruding time resolution (PV), APTTV, fibrinogen, platelet counting, less often - determination of bleeding time.

Water and electrolyte composition in the physiology of newborn children

Unlike adults, the physiology of newborns is more sensitive to the loss of water with breathing and through the mucous membranes. The proper moisture content of the inhaled air and the establishment of the necessary humidity of the environment can minimize these losses. The loss of fluid in the "third space" occurs during extracellular sequestration, which arises as a result of inflammatory defeat of capillaries in response to surgical intervention and sepsis. These losses are associated with a decrease in the total volume of circulating fluid, despite the weight gain. Patients with this type of liquid loss need intravascular volume. Urine release (1-2 ml / kg / hour) and urine concentration are good indicators of water status and blood circulation. Other methods of evaluating the water volume in the physiology of newborns are dynamic weighing, determining the level of electrolytes, acid-base balance, monitoring hemodynamic parameters (pulse, blood pressure, FVD). Intravenous infusion therapy is divided into three categories: resuscitation infusion therapy, supporting and replacement therapy.

Feeding newborns

The nutritional needs of the child differ depending on age. When choosing nutrition, it is also necessary to take into account the nutritional needs, ensuring growth, especially a small child. For example, the main nutritional needs of the premature newborn are 50-60 kcal / kg per day; And for normal growth - twice as much. In the pathology of a newborn or presence of less than 1000 g, the need for calorie food is even more. Carbohydrates (approximately 4 kcal / g) provide a majority of non-pecked calorie content; Fats (9 kcal / d) - the remaining part. Essential fatty acids (linoleic and linolenic) must be present in the child's diet, at least twice a week. High protein need is needed to compensate for the relative nitrogen deficit. Physiology of newborns need the same eight essential amino acids as adults, as well as histidine. Newborn need the same nine amino acids, as well as cysteine \u200b\u200band tyrosine, premature children - in all listed amino acids plus Taurine.

Nutrition of newborns can be carried out both enteral and parliantly. Enteral nutrition for the physiology of newborns is preferable, however there are certain clinical situations, for example, the impossibility of sucking or long gastroparta, which can limit it. In these cases, enteric power can be carried out through the nasogastric, the referee probe, gastrostomy or the euyutrosty. Best food is breast milk. It provides 70.5 kcal / 100 g, which corresponds to the same calorie content of most children's mixtures produced. Chest children, younger and older children, unable to absorb enteral nutrition, for example, with necrotic spoken colitis, pancreatitis or short intestine syndrome, can receive parherteal nutrition for a long period. With total parliant nutrition, monitoring the position of the catheter with periodic x-ray control, the frequent laboratory determination of the electrolyte composition, residual elements, vitamins is required.

The article has prepared and edited: a surgeon doctor

For the newborn period, the following basic needs are characterized by; sleep; drink; allocate move; communicate; avoid danger; be pure; to be healthy; Maintain constant body temperature.

Anatomy-physiological features of the newborn

The infancy period includes children from 1 month to 1 year (12 months).

The main feature of the infancy period is the high rates of physical and neuropsychic development on the basis of accelerated metabolic processes.

In many ways, the structure and functions of the basic systems of the body preserve the same features that were HARD for the newborn period:

1) abundant blood supply

2) reduced protective fs

3) the imperfection of the regulatory f-thies of nervous and endocrine systems.

NERVOUS SYSTEM

By the time of birth, the least developed. The mass of the brain in relation to the mass of the body is 1/8-1 / 9 part, in an adult 1/40 part. Swirl grooves are formed, weakly expressed with age, are more numerous, relief, especially in 5-6 years. The cerebellum is developed weak. The movement of the child is not coordinated. Myeline shells of nerve fibers are absent, the brain fabric is rich in water, its blood supply is more intense than in adults. The arterial network is better developed than venous. Nervous cells are the same as in an adult. The spinal cord is better developed than the head. The conditioned reflexes are well pronounced.

Leather and her appendages

The horny layer is thin, the epidermis juicy, loose. Blood vessels of the skin are wide, form a thick network. Potion glands are formed, but their ducts are developed weakly and covered with epithelial cells, so up to 1 month. Potting is not observed. The sebaceous glands are still intrauterine, their secret forms "cotton lubricant". Skin F-Nations: Protective, Distribution, Teroregral, Respiratory, Restorative, Vitamin-Fashionable. The umbilical wound after the dumping residue remains on the 3-4th day. Heals to 7-10 days of life, epithelized by 1 month.

Bone-muscular system

Poor mineral salts, a lot of water and organic things. The bones are flexible, rarely break, but are easily deformed. Large spring is located between the frontal and dark bones, closes by 1 year. All day-shaped all lateral springs are closed. Spring is needed for soft passage by generic paths. The spine does not have bends, straight. The teeth are not visible, but they have a root. The formula X \u003d N-4, where the number of the child months is up to 24 months (by 2 years) the milk bite (20 teeth) is fully formed.

Measures to prevent bone deformation in children of 1 years of life: 1) rational breastfeeding. 2) Prolonged stay in the fresh air. 3) Massage and gymnastics. 4) adequate physical exertion. 5) Sleep on a solid mattress without a pillow. 6) Change of position on hand and crib. 7) Free swaddling.

RESPIRATORY SYSTEM

Nasal shorts of small sizes. The bottom nasal turn is absent due to the horn of the nasal shells. The throat is a narrow, but auditory or Evstachyeva pipe that connects with the middle ear as a result of this, children often sometimes squeeze the larynx short, wide, funnel-shaped form with a narrowing in the field of refrosion space. Voice ligaments are short, and the voice slot is narrow as a result of which stenosis of the larynx often appears during laryngitis. The trachea is narrow, cartilage soft, can fall and can cause congenital string - rude snoring breathing with expiratory breath. Bronchi soft, prone to falling. Right bronchus is a continuation of the trachea. Faceless is small, low-handed, prone to the development of edema, atelectase, emphysema. The diaphragm is located higher than in adults.

THE CARDIOVASCULAR SYSTEM

The heart -20-25 of the vessels are well developed, but the arteries are better developed than veins. The pulse is relatively accelerated, arrhythmic, reckon in 60 seconds. Health systolic-70/75 mm.rt.st.

URINARY SYSTEM

Kidney anatomically immature. Ureterals are wider and convinced. The bladder is relatively higher than that of an adult. Muscular layer is poorly developed due to this, involuntary urination appears due to the underdevelopment of the regulatory F-CNS. Ureyeing channel-0.5-1 cm in girls, 5-6 cm in boys.

DIGESTIVE SYSTEM

In the oral cavity there are many devices - Bisha pillows - fat lumps in thicker cheeks, rolic-shaped thickening along the gums, folding on the mucous membrane of the lips, relatively large tongue. Salivation is weak. Food 10-11 cm funnel-shaped. The stomach has the same departments as in adults. The sphincter of the entrance part of the stomach, cardiac, is poorly developed, and the pyloric part is well developed as a result of being joining. The volume of the stomach is 30-35 ml. The child is born with a sterile intestine. Microflora depends on the type of feeding. The original Cal-Mekonium-thick viscous mass of dark green or olive color, without smell, stand out 2-3 days of life. With breastfeeding from 4-5 days of life, a chair is 1-4 times a day, a magazine, homogeneous, golden yellow with an acidic smell. With artificial feeding - 1-2 times. The chair is dense, light yellow, homogeneous, with a grinding smell. The liver is the largest body that takes half the abdominal cavity, performs from under the right hypochondrium by 1.5-2 cm.

The main problems of the newborn period

Border states of newborns

Transient (physiological) are not diseases, but require more attention and necessary measures.

1) Physiological loss of body mass in 100% of newborns and manifests itself on 3-4 days of life, Max. acc. 10% of the initial mass, and by 7-10 days the weight is restored.

Causes: Eats little, Water isolation through the skin and lungs, water loss with urine and feces, ochopling of the oily water, drying of the umbilical residue.

Tactics: Early applying to the chest, feeding on demand, fighting hygoglactic, child weight control.

2) transient erythema leather (redness)

Simple - redness of the skin due to the expansion of the vessels of the skin due to the powerful effects of the external environmental factors for the newborn skin receptors. Saves from several hours to 1-2 days.

Toxic (allergic reaction) - occurs on 2-5 days of life in the form of hyperemented spots, papules, vesicles, except palms and stop. The rash fade in 2-3 days. Can go to peeling.

Tactics: Skin care, hygienic bath with rum permanganate potassium.

3) transient fever

It manifests itself on 2-3 days of life, T. 38-39C, thirst, leather and mucous dry. After 1-2 days, T. is normal.

Causes: Little fluid flows into the body, high protein content in colostrum, overheating.

Tactics: Extra drink 5% rr glucose.

4) Jaundice - staining of the skin and mucous membranes (jaundice) without impairment of well-being. Cases of 40-60%. Appears for 3 days. The maximum reaches 4-5 days. By 7-10 days of life disappears.

Cause: The decomposition of the "susceptible" intrauterine erythrocytes with the yield of hemoglobin, from which bilirubin is formed, because The liver is temporarily not able to translate the indirect bilirubin (poison !!!) in a straight line, so it accumulates in the blood and goes into fabric and cries them.

Tactics: Control over the condition, additional drinking 5% r-r glucose, UFO.

5) Hormonal crisis - the transition of sex hormones of mothers to the blood of the fetus in the antentent and intranatal period or comes with Mother's milk. May appear in the form: 1) physiological mastopathies in boys and girls. The child has a symmetrical loading of the mammary glands without signs of inflammation, sulfuric chickens. It is manifested by 3-4 days, the maximum reaches for 7-8 days, disappears in 2-3 weeks. 2) At boys swelling scrotum, in girls-big sexy lips. It passes symmetrically without treatment. 3) Vulvivogenitis in girls is the release of gray-whitish separation from the germ, sometimes brown. Appears in the first days of life, disappears to 3 days.

Tactics - skin care.

6) UGRI (Milium) - blockage of the sebaceous glands is plentiful secret. Look like whiteish yellowish nodules of 1-2 ml. More often located on the wings of the nose, the nose, forehead, chin. It holds to 2-4 weeks. Treatment does not require.

Tactics - 2-3 times a day, wash the weakly-pink Rhr permanganate potassium.

7) Mochid kidney infarction - the deposition of the urinary k-you in the form of crystals in the wake of the urinary channels. The reason is the decay of the large number of cells in the particular protein metabolism. Water becomes muddy, yellow-brown. On diapers after drying the yellow stain or sand. Detected by 3-4 day of life. Within 7-10 days disappears.

Tactics - drink 5% rr glucose.

The immediate connection of the child with the mother's body stops from the moment of birth.

The newborn makes a cry, and at the first sigh, the air penetrates his lungs. From this point on, the child begins to breathe independently, and later to eat.

The first period of the child's life begins, the so-called newborn period, which lasts 3-4 weeks. The child falls into a new, unusual Wednesday for him.

External conditions can easily have a harmful effect on it. Good care will help the child adapt to new living conditions.

Recall some anatomy-physiological features of the newborn.

The main feature is the presence of a balance poucher cord. Usually, the newborn is in the maternity hospital, Pupovina does not have time to disappear. A bandage imposed on the umbilical wreck cannot be touched.

If the umbilical cord disappeared, then nothing but the dressing sterile or purely washed and swallowed by a linen bandage should not be done. As a last resort, it is recommended to pour the place of deposition of the umbilical sources - the umbilical wound - white strepticide powder. Care for the umbilical wound requires greater experience, so it is better if it will make a patronage sister of children's consultation.

In children of the first two weeks of life, a severe disease may occur with poor care - a navel septice (blood infection).

Body type The newborn is extremely different from the physique of an adult. The ratio of individual parts of its body is completely different: the length of the newborn head is equal to the length of the length of the whole body, while in an adult head length is only 1/7 - 1/8 of the body length. The child has a short neck: the head seems to be on the shoulders. Short lower limbs appear.

Leathernewborn is very gentle and thin, as a result of which it is extremely raw. It is easily arising with diameters, abrasions, scratches, through which pathoral microbes can penetrate and cause suppuration. On the shoulders and top of the back, the skin is covered with a fluff. In premature babies, this cannon is curly and covers, except forehead and cheeks.

On the 2-3rd day of life, the skin becomes land and begins to peel. The peeling happens in the form of thin scrapers, plates or grains resembling bran. It lasts about a week.

The skin of the child at birth is covered with a raw lubricant, released by the skin of the squeezing glands. This lubricant intracolod protects the skin from turning the surface layer, protects against the action of spindlewater waters, and during childbirth, it contributes to a lighter passage of the child through the generic pathways of the mother.

The skin of a newborn bright pink color. It depends on the fact that it is very close to the surface layer, a horn, which is very thin, is a thick network of blood vessels.

On the 2-3-4th day after birth, the bright pink skin color goes into the yellowish. There is so-called physiological jaundice. It is observed by almost all children. This jaundice is nothing dangerous for the child, although it happens sometimes very sharply expressed. After 3-4 yasteries, the skin passes, and the skin gradually takes its normal pale pink color.

Sweet glands at the time of birth are weakly developed and develop as the child grows.

Shan glands are already well developed by the time of birth. There is a lot of child on the skin of the child, and they allocate abundantly fat, which is especially noticeable in the sculpture of the head, where the crusts in the form of scales covering the entire head are formed. It is nothing but a dry fat, mixed with dust, hairpins and the steroid cells of the surface layer of the skin. When careing, they need to consider them, since, thanks to the contact of the microbes, inflammation of the skin can begin.

The skin performs a very important protective function for the child, participates in the process of respiration - carbon dioxide and water is distinguished through it. The skin has the finest branches - the end of sensitive nerves, due to which tactile, pain and temperature sensations arise.

Leather is an important body for the child's life. Therefore, skin care requires great accuracy and due attention to both the mother and caring persons.

The mucous covers are extremely gentle and easily wounded. The slightly slightest, even imperceptible scratch or abrasion, so that microbes or mold fungus penetrate there.

As a result, white raids appear on the mucous membrane of the mouth, the thrush develops, which sometimes the mothers are completely incorrectly considered mandatory and called "color".

Muscles in the child Initially, weakly developed. Despite this, the muscles of the newborn are in a tense abbreviated state. As the child grows, this muscle tension weakens, movements become free, then the muscles increase in volume and are made more elastic during palpation.

Body temperature The newborn is unstable, since its body cannot produce enough heat and maintain it. Therefore, the child is very quickly cooled, even at the usual ambient temperature, and also overheats quickly if it is overly rocked.

Gradually, the newborn adapts and gets used to the new conditions for it. The body temperature is set to 36.6-37 °.

Bone system Child, i.e. his skeleton, presents some features. He is softer and more elastic, since they have a lot of cartilage tissue.

The newborn has no cranial seams, i.e. there is no complete battle of the dark and frontal bones of the head. Between them in front there is a soft place, the so-called big spring. As the cartilage groves it is replaced with a dense bone tissue.

The head of the child, passing through the generic paths of the mother, is somewhat squeezed out of the sides and stretches upwards or the stop, and the bones of the skull are approaching one to another. Therefore, in the first days after birth, the head of the newborn has an irregular form. In the future, it gradually aligns independently. Trying it should not be aligned. Often, during childbirth, a generic tumor is formed on the child's head, which after a few days is solved by itself.

The legs of the newborn are a bit curved, it is caused by the intrauterine position of the fetus. A healthy child has legs gradually straighten up. Therefore, tight swab is unnecessar and harmful. The newborn, due to the increased tone of the muscles, holds the hands bent in the elbows, and the legs with the belly. This situation is for him the most convenient and usual before birth. Only for a short time, the newborn extensions his arms and legs, and then bends them again. It should not interfere with these movements - they need a child. In addition, these movements contribute to the release of gases from the intestine, which sometimes bother the child.

The digestive bodies of the newborn also have their own characteristics that need to know to properly care for the child. The oral mucosa is bright red and rather dry; It can be very easy to damage even cautious touch, so the newborn is not recommended to wipe the mouth in any way. The salivary glands of the child begin to allocate saliva from the 3-4th month, while there is plenty of salivament.

The stomach and the intestines of the child in the first months are able to digest the natural food for it, i.e. breast milk. Sometimes the child occurs various kinds of deviations from the normal process of digestion: tightening, vomiting after feeding or after a while not curled or curled milk, the bloating due to the accumulation of gases.

The milk digested in the stomach and intestines is absorbed through the walls of the intestine in the blood and is used to build new cells of the growing organism.

If the child jumps often, it is necessary to monitor its weight. If the weight decreases, you need a child to show a doctor consultation. In healthy children, joining passes by 3 months.

The process of digesting and promoting food casket in thin, and then in thick intestines, the formation of feces and their allocation through the rectum in a newborn baby has not yet been established. There is an accumulation of gases and the intestinal bloom, which causes a sharp concern, as well as rapid or, on the contrary, rare feces of various colors and species.

During the first year, digestive bodies acquire the ability to digest and absorb cow's milk and other types of food - vegetables, berries, fruits, meat, bread, etc.

When feeding with breast milk, a child's chair is 3-4 times a day, feces have a yellow color and an acidic smell. Gradually, the chair becomes less often; In the second half of the year it happens 1-2 times a day. When feeding cow's milk breastplaces, their color is darker. When switching to the overall meals, close to the total normal food of an adult healthy person, the chair becomes a dark color, a thick consistency.

In an adult person, the intestine is 4 times longer than its growth, and the child is 6 times. This relatively large length of the intestine is explained by the fact that the child needs relatively more food than an adult person, if we consider the amount of food per kilogram of weight.

For the same reason, the child has a relatively large liver. All nutrients from the intestines are neutralized in the liver, after which they come to the total blood flow, are distributed throughout the body and are used to build new cells for complex metabolic processes in the child's body.

Respiratory organs The newborn is still imperfect. Holes for nostrils, nasal moves and other respiratory tract (larynx, trachea and bronchi) relative to narrow. Upon rapidly, the mucous membranes swell, as well as when the milk droplets hit the nose or larynx (when jeeping), the breathing makes it difficult and the child cannot suck normally.

Therefore, the correct position of the child during feeding, systematic care of the nose is extremely necessary in order for the respiratory paths of the newborn to remain healthy.

The shape of the chest in the child's barrel, and not a cone-shaped, like an adult. The intercostal muscles are still weak and therefore the inhalation of the child is superficial. The deeper the person breathes, the more oxygen he inhales, the better his lungs are ventilated. In a child, breathing is superficial, i.e., when breathing, he inhales a relatively low air for one breath, and to provide an organism with oxygen, the child breathes more often than adult.

The air who breathes the child should always be clean, so you need to play the room well, where the child is located, to be with him in the fresh, clean air. It is impossible to twist tight and swading a child with a handle, as the chest is squeezed and breathing difficult. The misfortune of breathing the child depend on the insufficient development of the respiratory center in the brain, they pass gradually during the first months of life.

Heart of a child It differs from the heart of an adult in that it works incorrectly due to the imperfection of the nervous system, although the child can be completely healthy.

This malfunction of cardiac activity gradually passes.

The heart of an early age child is relatively more than an adult. Vessels, especially large, relatively wider than an adult, which makes it easier for the work of the heart.

Heart reduction is determined by the pulse. The pulse has a newborn to 140 beats per minute, in the first year of life 130-110, at the age of 1-2 years - about 110 beats per minute; In an adult - 72-80 shots. Under the influence of minor reasons (motion, long-term cry, anxiety, etc.), the pulse can be sharply expensive.

The amount of blood relative to the weight of the body in an infant is almost twice as much as an adult. In its composition, blood differs little from the blood of an adult. The composition of the blood is rapidly changing under the influence of diseases, but it is quickly restored during recovery. The composition of the blood is influenced by the lack of fresh air, nutrition, etc.

Weight and growth of the newborn are different. A normal duddy child weighs at birth on average 3200 grams (boys) and 3000 grams (girls). In individual children, birth weight can range from 2,800 to 4500 grams, and sometimes even higher. Children weighing from 1000 to 2500 grams are premature.

Growth (body length) of a newborn, an average of 48-50 centimeters (from 45 to 55 centimeters).

During the first 3-5 days, the initial weight of the child in most cases is reduced by 100-200 grams and more.

From the 4-5th day of the child's life, the weight begins to increase and usually reach the 9-12th day reaches the initial value.

The initial reduction in weight depends on the peculiarities of the newborn period: drying and deposition of umbilical cord, lunching the upper layer of the skin, highlighting the original feces. In the first days, the newborn sucks from the mother's breast only a minor amount of milk. The smaller the milk at the maternity hospital, the slower it stands out, the more the child loses in the weight. Therefore, the primary children lose more than the subsequent, since the first-night milk in the first days are less than in subsequent births. For the same reason, children with a large initial weight lose in weight more than small, weighing little, as the first need for food more.

It is very important to observe the weight of the child during the first year of his life, since changes in weight along with other signs that will be discussed below, make it possible to judge the normal physical development of the child and, in particular, a sufficient number of food produced by them.

By 6 months, the child doubles his weight, and by the end of the first year of life it triples him. On average, in the first half of the year he adds 600 grams per month, in the second half of the year 400-500 grams; For the second year he adds 2500 grams, on average 200 grams per month; For the third year of life-150 grams, i.e., about 150 grams per month.

The increase in the body length of the child follows the same patterns. The greatest increase in growth falls on the first year of life - 25 centimeters, on the second - 10 centimeters, on the third - 7-8 centimeters.

Development of motor functions and psyche There is respectively the development of the central nervous system. The newborn baby does not hold his head, produces only a messy movement with their hands and legs. His movements are usually sluggish, slow. Sometimes the child shudders and produces quick movements with hands and legs. This is a normal phenomenon. In the future, it becomes more smooth. In the first days after birth, the child sleeps a lot and wakes up only for food. Tears in newborns does not stand out: the newborn screams, but not crying. He can not blink. The eyelids in the first days after birth will bewood, as a result of which the newborn is usually holding his eyes closed for a long time.

Occasionally you can observe the squint, which gradually disappears.

The newborn child is worried and shouts for any reason: Usually, if it lies in wet diapers, it is tightly wrapped, too warmly Ukutan is overheating, as well as in the presence of gases in the intestine. To eliminate these reasons, you need to follow the rules of care for the child and regularly feed it.

Sometimes a completely healthy child begins to shout without any external cause; It happens with improper care when the child is accustomed to ensure that it is constantly wore.

Development of the central nervous system, especially brain, in the first year of life goes very quickly. From the environment and internal organs, the child's brain receives various irritations through the senses, which corresponds to the strengthening or weakening of the activities of their bodies. The more the brain develops, the more accurate and better it responds to irritation.

The first glimpses of conscious movements appear in a child by the end of the first month. Simultaneously with the development of the brain there is a rapid development of static motor and mental functions in a child of the first years of life.

During the first year of life, the child's body is gradually increasingly adapted to existence.

Simultaneously with general development, the child can manage its movement authorities. At the age of one month, he lifts his head, for 2 months she keeps her tight, to 3 - there is enough objects with hands, and at 4 months it holds them for a long time. By 6 months, the child sits, by 8 months - it stands, keeping for some item, to 10 - freely stands, by 10-14 months begin to walk independently. By 3 years, the child overcomes obstacles, walks along the stairs.

For proper valuation physical development of the childyou need to know the laws of increasing its weight and growth.

Systematic observations of the child's weight during the first year of life from the newborn period are very important, as they give us the opportunity at any time to judge the progress of the physical development of the child.

Such are brief information about the anatomy-physiological features of a child of early age.

Knowledge of the child's body makes the mother deliberately perform many rules of care to ensure the child the right development.

Anatomy-physiological features of the newborn

Head of the newborn relatively large. It is 1/4 of the total body length, while adults are 1/8. The facial part of the skull is relatively small. Head Circle 32-34 cm and exceeds 2-4 cm. Chest circumference. Some seams are sagittal, etc., as a rule, are open, large spring people are also, and small - open in 25% of newborns. Most newborn head is covered with hair. Neat's neck is short and therefore it seems that the head is located right on the shoulders. Large spring has a rhombus shape of about 20 mm wide. Measure large springs should be from one edge to another (the angles are often moving directly in the seams, and the measurement in such cases inaccurately). The limbs of the newborn relatively short - 1/3 of the total body length; The difference in the length of the upper and lower extremities is almost absent. The limbs are located close to the body and bent in the elbow and knee joints. Weight and heightAlthough they give well-known fluctuations, are important indicators in assessing the development and maturity of a newborn. The average weight and growth rates of the newborn, according to numerous observations of foreign authors are as follows: 3250-3450 g for boys and 3150-3400 g for girls. Height ranges from 50 to 52 cm for boys and from 49 to 51 cm for girls and 50-53 cm (on average 52 cm) for boys and 49-51 cm (average 51 cm) for girls. The percentage of duplicate children with weight of less than 3000 g in recent years is becoming less, and children with weight of more than 3000 g - more. Lower weight limit for normal fetal at birth 2500 g; With weight more than 4500 g Body temperature in newborns Due to the well-known imperfection of thermoregulation fluctuates in significant boundaries. Measured PER RECTUM, immediately after birth, it is 37.7 - 38.2 °. The skin of the newborn Smooth, elastic, rich in water. The superficially located capillary network gives it a reddish color. In the first hours after birth, the leather limbs is sometimes slightly cyanotic, but this should not cause anxiety if there are no other symptoms (respiratory disorder, etc.). The skin of the newborn is covered with a gentle fluff (Lanugo), especially in premature. Through the skin, the child receives the first sensations of heat and cold, touch and pain. The skin is and respiratory organ. The excretory ability is also good. The protective function of the skin is not sufficiently developed, so it is often an entrance gate for infection. Subcutaneous adipose fabric Well developed, although there are individual differences. It accumulates over the past two months of pregnancy and increases rapidly in the first 5-6 months after birth. Skin appendat develop from primary epithelial embryonic cells. Pasching hair covers the skin of the whole body, with the exception of palms, stop, near-gun areas, lips, penis heads in boys and hail lips from girls. The hair on the head is sometimes pretty long, sometimes barely noticeable. Eyelashes, as well as hair in nostrils and in the outer auditory canal are perpendicular, and the rest are tilted to the body surface. Each hair is associated with the hair follicle. Daily hair growth is 0.2-0.3 mm. The mucous membranes in the negenous period, but dry, as the amount of glands in them is scarce. The elastic tissue of the mucous membranes is poorly developed, contains an abundance of blood and lymphatic vessels. This explains the pink red color of the mucous. Muscular system. In the newborn, it is not well developed enough. Muscular fibers are thin with well-developed interstitial cloth. The muscles in the newborn constitute 23% of the total body weight, and in adults - 42%. Especially weakly developed muscles of the limbs. After birth, the neck muscles and significantly later muscles of the body and limbs are developing. . Nervous system. At the time of birth, the nervous system, especially c. n. C, did not reach its full development. Moreover, the phylogenetically older departments of it (spinal cord, etc.) are significantly better developed than the young (brain, etc.). Nervous fabric of newborns contains a lot of water. Brain Relatively large - 350-400 g, the largest organ of the newborn. Boys have a brain weight by 15-20 g more, respectively, their greater common weight. Big large hemispheres relative to thin. The gray matter of the brain is not degraded enough from white. Large grooves of the brain are planned. However, they are not always clearly expressed and, in general, less deep. Some small furrows are absent. The bark of the brain after birth is weakly functioning. Cerebellum The newborn is relatively weakly developed, with shallow furrows and slightly oblong shape. Medulla Very well developed. It contains a vital respiratory center, etc. Spinal cord It has an almost complete structure and functional maturity. In newborns, it is relatively long - from 14 to 16 cm, weighs 3-4 g. Spinal fluid The newborn is under weak pressure. For a newborn, a number of reflex movements are characterized, providing sucking and swallowing. In connection with the act of sucking, there is also so called. Trump reflex is a trunk-like pulling of lips while irritating the cheeks in the corners of the mouth. Grass reflex (Robinson) is also positive. When touching the inside of the palm of the palm, the newborn squeezes so much and keeps the subject, for example, a finger filed to him that the child can be lifted into the air. Positive in the newborn and crush reflex (moro). If you put a baby on your back, hit the pillow or quickly pull out the diaper from under it, the vestibular receptors annoyed, with the result that the child, opening the handles, raises them up and kinut. The presence of this reflex later 3-4 months some authors consider a sign of the lag development of the child. Bauer crawl reflex is positive. If you put a newborn on the stomach and touch your footsteps to his footsteps, he tries to crawl forward. When touched to the cheek, the newborn turns the head to the same side; When one cheek is pulled, twitching another appears. The eye reflex in the newborn is expressed not only in the narrowing of the pupils and the closure of the age, a sharp folding of the head back. Hearing The newborn is developed in the first days of life. Touch well developed. The child reacts instantly to touching the skin and mucous membranes. The sensitivity of various skin areas is not the same. It is stronger than the face, hands and legs and weaker on the back. Changes in temperature The newborn perceives from the moment of birth. Newborn has and painful sensitivity. Cross, as a rule, causes a motor reaction. Vision Develops gradually. The newborn is reduced to the feeling of light. The newborn has rally, called the physiological, which disappears after the first month. Pupils react to light, sometimes slightly slower. Sharp light causes the closure of the eyelids and described above the eye reflex. Development of the movements and psyche of the child Closely related to the development of the nervous system and environmental conditions. The latter should ensure the harmonious development of individual analyzers in the period of newborn.

Bone System: At birth, the bone system of the newborn contains little dense substances and a lot of water. Soft bones, elastic with multiple blood vessels. Most of them in structure is close to cartilage tissue. The bone plates are randomly located, and the Gavers canals have the wrong shape. Rib cage Consists of cartilage tissue and is a truncated cone or has a barrel-shaped form. Flexible ribs are attached perpendicular to the chest bone. Intercostal spaces are narrow, intercostal muscles are weakly developed. Lower aperture is wide. The dimensions of the lungs are relatively large - the pleural cavity is almost absent. The diaphragm is located high - at the level of the VIII of the breast vertebra on the right and at the level of the IX level. It is a thin plate - muscle on the periphery and tendon in the middle. Breath type - bone-diaphragmal.

Vertebral pillar The newborn does not have the letter "S" characteristic of adult forms. This form of the spine takes gradually, when changing the position of the body from the lying in the sitting, and later to the vertical. Pelvis It is almost horizontally, and its height is relatively small. Sustaines Different with great mobility. Respiratory system. Like all other systems, respiratory organs at the moment of birth have not yet reached its full development. Nose of newborns Mal, with soft cartilage and narrow strokes. The nose mucosa is gentle, highly hyperemic and edema, which makes it difficult to breathe. The nasal moves are narrow - the diameter of them is 2-3 mm. The tear-nasal canal is wide. Table glands operate on the first day of life, but quite weak. The newborn is usually crying without tears. Exceptions are possible. Putinous sickles (sinuses) are underdeveloped with the exception of ethmoidal. Gaimorov sinuses are deep gaps. Although rarely, but the inflammation of the cavities is possible. Eustachian tube Short and wide, located in a horizontal direction. With inflammation of the nose, pharynx, etc. The infection is easily propagated from the nasopharynx to the middle ear. Throat, larynx, trachea and bronchi Narrow with soft cartilage. The pharyngeal lymphatic ring is poorly developed. The high location of the larynx, approximately at the level of the II cervical vertebra, and the corresponding slope of the oral cavity ensure the unimpeded passage of food, bypassing the inlet of the respiratory throat, which allows the child to breathe freely during feeding. Trachea bifurcation is located at the level of the III of the breast vertebra. Right bronchus is a direct continuation of the trachea. Light bronchi narrow, cartilage soft, contain few elastic fibers, mucously rich in blood vessels. oscillations. The cardiovascular system. After the birth of a child in the cardiovascular system, complex changes are associated. The influx of placental blood stops. Begins pulmonary breathing. DUCTUS VENOSUS ARANTII, DUCTUS ARTERIOSUS BOTALLI, FORAMEN OVALE, Upper vessels, etc., are gradually closed, and later refuse. Reconstruction of blood circulation, as already mentioned, closely related to the beginning of breathing. It is commonly with the advent of breathing resistance in the vessels of the lungs falls, Ductus Botalli and Formen Ovale are closed. Heart of a newborn relatively large sizes. Muscular fibers tender and short. Connecting and elastic tissue are weakly developed. The heart is located high and almost horizontally. The heart rate is determined in the fourth intercosta by 0.5-1 cm of the duck from the nipple line. Heart volume is about 18-20 ml. The walls of both ventricles of the same thickness - 5 mm. The lumen of the aorta and the pulmonary arteries are relatively wide. The backup power of the heart is large. Until the end of the first month, an electrocardiographic study indicates the well-known prevalence of the right ventricle, but this does not mean that in anatomical terms, the right ventricle prevails over the left. The clinical and radiographic study of the heart by the 5th day of life show a decrease in cardiac contours and shadows. This suggests that the increase is associated with the expansion of the ventricle, and not with the hypertrophy of the heart muscle. The relative width of blood vessels greatly facilitates the work of the heart. The walls of the vessels are thin, with a slight content of muscle and elastic fibers. The capillary network is well developed. The capillaries are short and the walls are easily permeable. Cardiac activity Accelerated. Pulse frequency from 120 to 140 shots in min. After the initial tachycardia (the action of the sympathetic nerve) and hypoxia, in some cases 2-3 days there is a belitative bradycardia. It is explained by the action of a wandering nerve, low body temperature in this period and favorable conditions for the supply of an organism oxygen through the lungs with a reduced oxygen and scant nutrition. Permanent tachycardia in newborns and infants is associated with a relatively small shock volume, which by the end of the first year gradually increases three times. After the first day, there is sometimes respiratory arrhythmia. The base of the heart often does not have the focus of the first tone. Enhanced cardiac activity is explained by the dominant role of the sympathetic nerve. The tone of the wandering nerve rises during the second year. Hooping Organs. The bone marrow is the main organ of blood formation. Additional hemoral foci exist in the liver, spleen, lymphatic glands, reticulous endothelial cells, etc. Bleeliness during the neonatal period retains its embryonic nature. Along with mature blood cells in the bone marrow, young uniform elements are also found. For the hematopoietic system in this period, instability is characterized in relation to harmful external influences. But there is a huge regenerative ability - loss, as a rule, are quickly and fully restored. It is believed that the blood-forming of the bark of adrenal glands, the pituitary gland and sex glands regulate. The lymph nodes relatively large. The capsule is thin. Almost the entire lymphatic system participates in blood formation. Lymph nodes are a natural barrier for infections. However, their protective function is completely insufficient to prevent the generalization of infectious processes in newborns. For research, cervical, axillary, elbow lymph nodes are available. Almonds are smallCoated with a dense connective membrane, have a smooth surface. Later on their surface are formed recesses. Sometimes, although weakly, adenoid vegetation is expressed. In exceptionally rare cases, they are involved in the process for the disease of the newborn rhinitis, pharyngitiset al. and contribute to supporting infection in this area. Digestive organs. The development of the digestive system in the newborn is not completed. In the first days and months, the child can not chew food. Partial discoordination of the motor and tonic function of the gastrointestinal tract is observed.

Oral cavity The newborn small is covered with gentle, bright red, easily vulnerable mucous membranes. Language is relatively large. At birth, it sometimes fills the whole oral cavity. The solid sky is slightly arcuated, with a multitude of folds of the mucous. Pronounced folding has a mucosa gum. A special device of the language, lips (with very developed muscles), cheeks, etc. facilitates the act of sucking. Salivary glands. Their secretion in the first weeks of the child is weakly expressed. Contains a small amount of mucous cells, connective tissue and blood vessels. The saliva contains birds, maltase, lysozing, electrolytes - potassium, sodium, calcium, etc., as well as mucin. Acid milk mixtures are twice as large as milk. Sleeping secretion decreases when moving to another food. Sucking It is a complex reflex act. Its center is located in the oblong brain. During sucking, the child captures the nipples and the lips surrounding it, and the lower jaw and the language is released by the book. An irritation when capturing the nipple is accompanied by a reduction in its muscles, the nipple is lengthened and becomes harder. Movement of the language, jaws, lips, etc. Create a closed cavity with negative pressure, the milk is saturated from the pectoral channels and enters the mouth. On one swallowing movement drops 3-4 sucks. Often during sucking a child swallows and air - Aerofagi. Defects in the development of a nipple or oral cavity, the incorrect application of a child to the chest creates conditions for defective feeding.

Esophagus The newborn is relatively long, and the distance from the jaws to the entrance to the stomach is about 16-18 cm. The mucus of the esophagus gentle, rich in blood vessels. Muscular layer and elastic tissue are weakly developed. The glands are almost absent. Stomach Almost round, occupies horizontal or slightly oblique position and most of it is located in the left hypochondrium. The cardiac part of the stomach corresponds to the level of X-XI of the breast vertebra, and the gatekeeper is the level of XII thoracic or I lumbar vertebra. At the time of birth, the prematurity part of the stomach is well decorated, and the entrance to the esophagus is relatively wide. Muscular stratum stomach is poorly developed. The gastric mucosa is relatively tender. The epithelial layer and the gland of the stomach consist of high, cylindrical cells separating the mucus. The capacity of the stomach is about 20 ml on the first day, 60 ml by the end of the first week, 70-80 ml in the second week, 90-100 ml on the third week and about 120 ml by the end of the first month. Gastric secretion begins with the moment of food intake in the mouth or straight in the stomach. Later is the conditional reflex. The gastric secret contains birds, pepsin, laboft, hydrochloric acid, etc. enriched milk, very cold or hot, like other cold or hot liquids delay the gastric secretion and slow down the evacuation of gastric content. With natural feeding, the emptying of the stomach occurs after 2-2.5 hours. The duodenum of food is exposed to trypsin, lipases, amylases, pancreatin, etc. n. from. and endocrine glands. Intestines. At the end of the first month of life, the bowel length is an average of 3 V2 m. Its mucosa is rich in blood vessels. Muscular and elastic layer are underdeveloped. The smaller the child, the greater the permeability of the intestinal wall. Through it, products are not completely digested food, microbes, toxins, hormones and various types of immune bodies. The intestinal motor function consists of pendulum movements that facilitate suction, and, peristaltics, with the help of which is moving food. Food is absorbed in the small intestine, and water is preferably in a thick. Liver of newborns relatively large sizes, its weight is 4.4% of the total weight of the newborn (in adults - 2.4%). The liver is rich in blood vessels, poor connective tissue, the shares are not clearly delimited. There is an education and allocation of bile, but its number is relatively small. It contains a small amount of bile salts and acids, more coloring substances, mucus and water. The function of the liver is associated with digestion, circulatory, with carbohydrate and protein exchange. Glycogen-forming liver function is well expressed. Its defective function is insufficient - delaying and neutralizing microbes and toxins. Spleen well developed. After birth, its weight is rapidly increasing (from 7.2 to 16.5 g), diving by the end of the sixth month. It is rich in reticulous endothelial cells. Pancreas. The weight of the pancreas is 2.5-3 g. It consists of a large number of connective tissue, rich in blood vessels and poor Parenkhima. The outer and internal secretory activity of the pancreas is well expressed. A duodenum distinguishes pancreatic juice containing lipase, amylase, trypsin, etc. Mekonium. Formation of semination begins with 3-4 months of intrauterine life. Sometimes it is distinguished from the intestine more intrauterine (for example, during asphyxia) or during childbirth - with a berry prey, etc. But, as a rule, the extinguishing of meconium is observed in the first 3 days after birth. It is a dark green or black homogeneous mass odorless. With congenital atresia, bile ducts has a pale gray. It consists of deskvamated epithelial cells, mucus, digestive juices and absorbed by the octopling waters. The total number of it is 60-90 g. With a microscopic examination, there are cells of a flat epithelium, Vernix Caseosa, fat drops, bilirubin and cholesterol crystals, etc. at the time of birth of Mekonia sterile. Already after 12 hours, it finds various microorganisms: streptococci and staphylococci, enterococci, BACT. Proteus vulgaris, BACT. Coli. Three days later (with an insufficient number of food received for 4-5 days), the MECONID is replaced by brown, greenish yellow, and later and golden yellow piercing feces with a sour smell. Initially, a chair in a child is 3-4 or more than once a day, gradually decreases to 1-2 times. With natural feeding flora of feces consists mainly of BACT. Bifidus. With mixed and artificial feeding - from BACT. Coli, BACT. Paracoli, BACT. Lactis Aerogenes, etc. GOOD SYSTEM. The separation system in newborns has a number of features. In a newborn, they are located relatively low - the upper pole at the level of Xi edges, the lower - at the level V of the lumbar vertebra. The magnitude of the kidneys is relatively large. Renal lochanks do not have characteristic features. At birth, tubular elements are underdeveloped. In premature babies in the renal cloth, the formation of glomers continues until the number of them will reach the number of glitters in the docking children (14-16). By the end of the first year, the intensive growth of the kidneys continues. The concentration ability of the kidneys in newborns is small. It is approximately 50% of the concentration ability in adults.

Ureterals are wide, winding, 6-7 cm long; Muscular layer of their walls is poorly developed. The length of them is 6-7 cm. The bladder in newborns is located high. With the maximum filling, its upper border can reach the navel. Lowering it into the cavity of the small pelvis occurs gradually. The wall of the bladder consists of a weakly developed muscular and elastic tissue and tender mucous membranes. The size and form of it largely depend on the number of urine gathered in it. The urinary bubble capacity is 50-80 ml. The urethra has well-developed epithelial folds and glands. Its length in boys is 5-6 cm, and the width is 0.5 cm. The cavernous part of the urethra is weakly developed. In girls, the length of the urethra - 2-2.5 cm, and the width is 0.60 cm. Sender organs. The outdoor genitals in the newborn are well decorated. The testicles in boys in a significant percentage of cases have already descended into the scrotum (for premature not complete Descendus testiculorum almost physiological phenomenon). Under the influence of thermal and mechanical irritations, the testicles are tightened upwards, which can be mistaken for cryptorchism. Dimensions of eggs: length - 10 mm, width - 5 mm, thickness 5.5 mm. In histological relations, the structure of the testicles is unfinished. There is a large number of intermediate cells; Seed tubules have a type of heavy. Prostate The newborn is relatively large, the vessels are wide and connective tissue loose. Most of the branched tubes, of which it consists, do not have a lumen. The secretion of the gland is poorly pronounced. Penis In terms of its structure, it is not significantly different from those of older children. Most boys have a physiological phimosis, which in severe degrees can become a pathological phenomenon. Girls large and small sex lips relatively large and cover the clitoris. In prematurenesses sender organs underdeveloped - large sex lips do not cover small. Hymen with a relatively large hole; Floor slot often gaps. Uterus Immediately after the birth of a child weighs from 3 to 6 g, its length is 35 mm. The mucosa is hyperemic, a cervix relatively large, test consistency. Vagina. Its length 25-35 mm. The walls are so close approaching one to another that there is only a potential cavity. The vagina is covered with hyperemic loose mucosa. Flat epithelium is in a strengthened proliferation state. The length of the ovaries is 12-13 mm. The connecting tissue in them is almost absent. In the central part of the ovaries often find well-developed grappes of follicles. Yellow body is absent. Primordial follicles are tightly adjacent to each other. Fallopiev pipes Significantly more winding than adults. Milk glands Locked above the IV rib on the nipple line. Well decorated. Consist of 12-15 poles. If there is no swelling, they are difficult to accommodate from the surrounding subcutaneous fatty fiber Endocrine system. Data on the functions of the endocrine glands during the newborn period is very scarce. Despite the fact that secretory activities begin immediately after birth, hormones are allocated in limited quantities. This insufficiency is compensated by hormones obtained and obtained newborns from the mother. In the period of the newborn, the forms of the thyroid gland is of particular importance, and the value of the thyroid gland is insignificant. These two glands come into effect as growth factors. The adrenal glands are of particular importance. Thymus It is characterized by large oscillations in weight, form and consistency. Its weight on average is 11.7 g (from 2 to 25 g). Variations exist in the histological structure of the gland. In some cases, lymphoid elements predominate, and in others - connective tissue, etc. Follicles of the fork gland are a combination of groups of epithelial and lymphatic cells. The newborn prevails the cortical layer. Warm iron affects the growth of a young organism and participates in neutralization of toxins. Thyroid The newborn has a shape of the horseshoe and weighs from 1 to 7 g (on average 3 g). His histological structure is close to the histological structure of the gland in adults. The colloid appears at the end of the intrauterine period and fills mainly peripheral follicles. Tyroxin and iodine exist in minor quantities. In the first months after the birth of iron, weakly functions. The thyroid gland is associated with the processes of the main exchange and has a stimulating effect on the sympathetic nervous system. It regulates the excitability of the nervous system as a whole and especially the cortex of the brain, has an impact on the cardiovascular system, on the processes of growth and ossification. The increase in the thyroid gland (Struma Neonatorum) can be observed during iodine deficiency for intrauterine development. It should not be considered that we are talking about congenital endocrinopathy, it is possible and a transitional phenomenon associated with the known hyperplasia of parenchyma gland. More often is observed in areas with endemic goiter. Increased thyroid gland can create difficulties in childbirth. After birth, the presence of an increase in the thyroid gland can be found out by taking a baby under the mouse so that the head leaned back. When it is increased, it is clearly visible. Parashydovoid glands, Number 2-6, represent small round or oval tales, dense consistency consisting of cylindrical epithelial cells. Connecting and adipose tissue is weakly developed. Insufficient development of glands sometimes leads to Tetania. The hormone of the parachitoid glands takes part in the exchange of calcium and maintains an acid-base equilibrium in the body. The glands of children fed to cow's milk, hypertrophied, which is not observed in children on natural feeding. Such hypertrophy is associated with a high level of phosphorus and a different ratio of calcium and phosphorus in cow's milk. Adrenal glands in newborns Relatively large - up to 7 g. The smallest weight is 0.80 g, the largest-12 g. The newborn weight of the adrenal gland belongs to the weight of the kidney as 1: 9 (in adults - 1: 28). The structure of the glands is not completed, and the function is weakly expressed. The cortical layer of adrenal glands is relatively well developed. Some authors believe that the bark of adrenal glands in newborns has the ability to synthesize all the necessary corticosteroids. In the first days of life, a significant part of the corticosteroids is distinguished in free state or in conjunction with sulfates. The ratio between 17-hydroxy and 17-deoxyactoroids in the urine of newborns is lower than in adults. Since the second week of life, a significant binding of steroids with glucuronic acid is determined. The function of the adrenal glands has an impact on the development of the brain, sex glands and child growth.

A newborn baby is significantly different from an adult not only the main anthropometric parameters (growth and weight), but also has a number of features of the structure and functioning of various organism systems.

The main feature of the newborn is its ability to intensive growth and development, which is accompanied by the organ level by morphological and functional improvement. At the same time, maturation occurs.

central nervous system

The subcutaneous fluid fiber of the newborn is characterized by the presence of deposits of the so-called brown fat, which is used for more efficient.

In addition to morphological features, the skin of the newborn is different from the skin of an adult and functionally. First of all, the role of the skin in the breath of the child of the first days of life is high. Therefore, it is unacceptable to apply an excess amount of substances impermeable to the skin on the skin.

In addition, the functional feature of the skin of the newborn is its high ability to regenerate (recovery).

Muscular system

The muscles of the newborn are not developed: their mass is only a quarter of the total weight, while in an adult this indicator reaches 45%. Muscular fibers of the newborn is much thinner than in adults, and their tone and power, respectively, weaker.

Bone system

At the cellular level, the bone system of the newborn is characterized by a high content of water at a low level of mineral substances. The child of the first days of life has elastic, flexible, softer bones than adult.

By the time the processes are not completed in all bones of the skeleton.

The head of the newborn is equal to one fourth of the total length of his body, and the bones of the skull are movable. At the point of convergence and two, diamond-shaped large spring, the normal dimensions of which are 2.5 by 2.5 cm.

The spine pillar of the newborn is represented by a cartilage cloth.

The chest has a truncated cone form. Rib is placed horizontally, forming a straight angle with the spine, which to a certain extent limits its mobility in the act of breathing.

Respiratory system

Considering the respiratory system of the newborn, it should be noted that its nose is characterized by narrow nasal strokes, and the nose mucosa is thin and well equipped with vessels.